Self-Tracheostomy: Analysis of Google Trends

In late January 2024, a surge in Google Trends searches related to the term “tracheostomy” was observed in a small region of Central Italy (Figure). Google Trends is a Google analytics tool that enables the investigation of user search trends worldwide. Through this tool, one can identify the most searched keywords and popular topics within a specific time frame. Google Trends normalizes search data to facilitate comparison between terms. Search results are normalized based on the time and location of a query through the following procedure: - Each data point is divided by the total searches in the geographic area and time interval it represents, to compare relative frequency. Without this normalization, geographic areas with higher search volumes would consistently rank higher. - The numerical results are then scaled into a range from 0 to 100 based on the topic’s proportion among all searches on all topics.1 For many years, the importance of search trends in understanding health phenomena has been the subject of study.2 The surge in searches coincided with the publication of news regarding a case of self-inflicted tracheostomy in the city of Assisi, Umbria (Italy).3 A 63-year-old man, experiencing an allergic reaction and sudden respiratory failure, reportedly performed a tracheotomy on himself using a box cutter. He then presented to the emergency department, where a cannula was inserted through the selfcreated opening, and was subsequently transferred to the intensive care unit without any complications.3 Tracheostomy and cricothyrotomy are surgical interventions that carry potentially life-threatening complications and should only be performed by adequately trained health care professionals.4 We identified only 1 scientific article addressing a similar case,5 and we are unaware of whether similar situations have resulted in different outcomes. Depictions of such scenarios in fictional media, such as films,6 may influence individuals, particularly those with a high degree of self-assurance but lacking proper training, to attempt emergency tracheotomies unnecessarily. We concur with our colleagues5 that documentaries and health programs should always caution viewers about the potential complications arising from these procedures when performed by unqualified personnel. The spike in Google Trends searches for “tracheostomy” underscores the necessity for responsible public health messaging and educating the public about the risks of untrained and unsupervised medical procedures. Further research is warranted to investigate the long-term impact of media portrayals of such procedures and to develop effective strategies for mitigating potential risks.